Obesity has become one of the important factors affecting the entire management process of liver transplantation. Its impact is not only reflected in the increased risk of liver steatosis and ischemia-reperfusion injury in the donor, but also involves the increased technical difficulty during the perioperative period for the recipient, the increase in postoperative metabolic complications and poorer long-term prognosis. This article, based on recent relevant studies, reviews aspects such as the utilization of obese donors, the characteristics of adult and pediatric recipients, pre-transplant risk assessment and weight loss intervention, and post-transplant weight and metabolic management. Current evidence suggests that simply judging transplantation risks based on body mass index has limitations. Analysis of body composition, assessment of cardiovascular function and identification of sarcopenic obesity are more clinically valuable. For obese liver transplant recipients, in a multidisciplinary collaboration framework, emphasis should be placed on individualized screening, perioperative optimization and long-term follow-up management to improve the outcomes of the graft and the recipient.

Liver transplantation is currently one of the most effective treatment methods for end-stage liver disease， and early postoperative mortality （typically defined as within 30 or 90 days after surgery） remains a key issue affecting the prognosis of patients. This article systematically reviews the research advances in early mortality following liver transplantation， elaborates on the definition， incidence rate， and clinical significance of early mortality， and discusses related risk factors from multiple dimensions， including donor factors， the preoperative status of the recipient， surgical techniques， postoperative complications， and immunosuppressive management. Furthermore， it analyzes the development and application of risk prediction models based on machine learning and big data in recent years and compares the predictive efficacy of different models. Meanwhile， this article summarizes the limitations of existing studies and explores future research directions， so as to provide a theoretical basis for the early identification of high-risk patients and the optimization of intervention strategies to reduce early mortality rates in clinical practice.